The Pitfalls of a Second Opinion

Medicine is not mathematics, where a problem has a single correct answer.

The week before writing this, I saw a couple of patients for second opinions. This can be very tricky terrain, and I do my best to navigate skillfully. A casual remark on my part could damage the relationship between the patient and the doctor of record.

Here are examples of remarks that I believe are best left unsaid.

“Your doctor did what???”

“We don’t recommend that surgery anymore.”

“Sounds like you need a new doctor!”

“Have you considered hiring an attorney?”

“I agree with you that the doctor’s office was unprofessional.”

You get the idea. Other physicians who offer patients second opinions may have a different view on this. They may believe it is their role to make highly detailed medical recommendations as best they can, which may represent an acute therapeutic course change. They may even offer to take on the patient formally, a suggestion that would be expected to be welcomed by the dissatisfied patient.

Trapped in a medical labyrinth.

Keep in mind that second opinions are nearly always requested by patients and less often by referring medical professionals. Thus, these patients are dissatisfied with either their care or their medical status. Otherwise, they wouldn’t be seeking outside advice. So, they are apt to seize on any new recommendations reinforcing their view that their prior treatment was inadequate. This may be a false assumption, of course. An unfavorable medical outcome may result from excellent medical care. See how tricky this can be?

A second opinion is just that — a second opinion. It may not be a better opinion and can actually be an inferior opinion. At times, patients who are still dissatisfied or discouraged may seek a third opinion. Such patients may have to contemplate several new recommendations issued by the three doctors, all of which may seem reasonable. Imagine how bewildering this can be for patients and their families who are trying to find their way out of this medical labyrinth. Medicine is not mathematics, where a problem has a single correct answer. "What's the harm in getting a second opinion?" I hope readers now have a better answer to this.